Mill Valley author investigates the midlife brain

IT'S EASY to spot Cathryn Jakobson Ramin around Mill Valley. She's the woman cringing every time someone rides by on a bicycle, skates or skateboard without a helmet.

A head, she says, is just about the most valuable part of your anatomy.

"Your brain is really 3 pounds of fat with the texture of lightly scrambled eggs. People do not get that," says Ramin, who had repeated minor head injuries as a child growing up in New York.

Ramin knows a thing or two about brains - mostly because she thought she was losing her mind a few years ago.

"As I entered middle age, I noticed something happening to my brain. I told myself I was losing my edge, I was getting foggy," says Ramin, 50, a Mill Valley resident and longtime journalist who always relied on her sharp memory.

That was in her early 40s. A few years later, she began to realize she wasn't the only one.

So she took her journalistic skills and made herself a guinea pig in her quest to regain her failing memory and slipping concentration. Her book, "Carved in Sand: When Attention Fails and Memory Fades in Midlife," was published last month.

In print, she is just as approachable and lively as she is in person as she describes her two-plus-year foray into her brain that led her across the country to consult with memory experts, neuropsychologists, a longevity guru, nutritionists, trauma experts, psychopharmacologists and mindfulness experts. She also underwent all sorts of tests, PET scans and MRIs; popped numerous vitamins and prescription drugs, including Adderall, which is given for ADHD; played hours of brain-boosting games like Tetris and took salsa lessons.

As she crisscrossed the country talking to people, the same questions came up. But the main one, she writes, is "What allows some people to maintain their faculties well into old age, while their peers struggle?"

The first step to understanding, she says, is to acknowledge that there's a problem. "People do not want to acknowledge it because it has implications with aging and who we're going to be."

Ramin started her journey with Gary Small, a psychiatrist and director of UCLA's Memory Clinic and Center on Aging. A brain scan relieved her of one fear - she had no sign of Alzheimer's - but her memory and attention test indicated other problems. Later on in her research, she discovered she had an underactive thyroid and decreased levels of a hormone necessary for brain cells to work properly.

"I thought it was very important to find where the holes were," Ramin says.

Getting to know her particular issues was helpful, but that doesn't mean that people have to spend thousands of dollars to understand their own.

Not always menopause

One of the biggest surprises she discovered from her research was that they shouldn't be too quick to explain away too much. Women tend to point the finger at menopause for everything from misplaced keys to misplaced cars in the shopping mall, she writes, when studies show that estrogen fluctuations only affect verbal memory. Men generally chalk it up to selective memory.

"What we normally attribute to aging can come from a variety of sources. Drugs, whether over-the-counter or prescription, create a powerful punch. Doctors don't always think about that," she says. "It's not just age. In fact, age is a very small part of it."

Head injuries and minor concussions like the ones she experienced as a child are, obviously, bad. So is stress - not so much the day-to-day, I'm-late-for-work stress but chronic stress early in one's life.

"People who grew up in a stressful environment will experience far more loss of memory in midlife," she says. The ramifications of post-traumatic stress disorder for those returning from Iraq are huge, she adds.

Multitasking is another problem for this generation. Women "are kind of designed to keep our eyes on more things at once, which is different (than multitasking). We have the ability to take in a great visual array, which explains why you know where things are in your house. But multitasking is having your brain doing several things at once," Ramin says.

That's not a great thing.

"It's very inefficient. The brain is not meant to do it," she says.

All multitasking does is lead to mistakes - lots of them. "It's staggering, because we're doing five things at once. It may be expected but it's not successful. Every time you make a mistake, you have to clean up the mess."

And all those antidepressants people seem to pop at the first sign of any unhappiness to mellow out? "If you're living in that midrange, it's because of the drugs' effect on your brain. Your memory, concentration, motivation and organization will be involved in a negative way," she says. "These drugs change the neurochemical balance. They alter it."

Downside of Adderol

Ramin discovered the down side of taking Adderol - one of the drugs frequently prescribed for attention deficit disorder - as well. "Adderol gave me a huge cognitive boost," she says. But "you don't have a lot of feelings." That impacted her ability to be connected to and present for her husband, Ron, and two children, Avery, 16, and Oliver, 13. "My humanity was compromised, too. For six months, I was enjoying my newfound facilities and at the end of every day, I would go into withdrawl, a pretty serious withdrawl."

As much as Ramin is concerned about those drugs, she is for hormone replacement therapy - if a woman can take it - despite recent controversial studies. She devotes a chapter to HRT in the book and determines that timing is everything. "There very well may be this window of opportunity" in the first few years around menopause in which HRT can help, she says. But after that, a woman can't change her mind and take it. "Talk about pressure on this generation of women!" she says.

By the time her book was written, Ramin says she "regained the abilities I had misplaced."

"In time," she writes "I got my mojo back - ideas meshed, names made themselves readily available and words flew from my brain to my fingers to the monitor screen."

'Proactive' baby boomers

The fact that Ramin's book joins hundreds of new books on how to enhance our memory and brain suggests that the baby boomers "are proactive," says UCLA's Small, author of "The Memory Bible" and co-author of "The Memory Prescription" and "The Longevity Bible." "They want to do something about it. They want to live better. But even with the promise of the baby boomers, there are a lot of people who are complacent. We have a big public health challenge."

So what works?

Engaging all our senses, as Lawrence Katz, a professor of neurobiology at Duke University, told her. "We're actually deceiving ourselves, with all this talk about how well connected the Internet has allowed us to become," she quotes Katz as saying. "The single best thing you can do for your brain is to just be around people in a meaningful way. That doesn't mean just working with people - it means genuine face-to-face interactions. The absence of human interaction is just deadly for the brain."

Exercise, too, as long as it's the right kind. "Reseach shows that aerobic exercise is extremely important," Ramin says. "All the mellow stretching and yoga is very nice for your stress level, but you need to get your heart pumping and sending blood into the brain."

Staying fit and making sure you get enough antioxidants, Omega-3 fatty acids and sleep are also important, she says.